About MRFTT

About

The Medical Research Foundation of Trinidad and Tobago (MRFTT) is dedicated to providing biomedical, behavioural, and structural interventions to effectively remedy the health and psychosocial needs of people living with HIV (PLHIV). The MRFTT accomplishes sustainable management of its patient population through expansive antiretroviral therapy (ART) coverage, improving patient outcomes, by providing state of the art training for healthcare workers (HCWs).

The Medical Research Foundation of Trinidad and Tobago (MRFTT) serves as a regional model for the Caribbean, providing optimal HIV prevention, care and treatment services for adults across the HIV continuum. - And through the ongoing development, dissemination, and use of research and best practices to provide a strong intellectual foundation for healthcare workers to monitor and improve clinical outcomes for patients with HIV and other sexually transmitted infections (STIs).

History

The Medical Research Foundation of Trinidad and Tobago (MRFTT) was established in 1982 by Professor Courtenay Bartholomew, then Professor of Medicine of the University of the West Indies (St. Augustine Campus), as a Non-Governmental Organization to meet the need for local research in the Faculty of Medicine at the University, and additionally, to serve as the impetus for fostering the growth of medical research within the region.

The Medical Research Foundation of Trinidad and Tobago (MRFTT) was established in 1982 by Professor Courtenay Bartholomew, then Professor of Medicine of the University of the West Indies (St. Augustine Campus), as a Non-Governmental Organization to meet the need for local research in the Faculty of Medicine at the University, and additionally, to serve as the impetus for fostering the growth of medical research within the region.

In the 1980’s investigations into the new mysterious illness that was emerging worldwide led to collaborations with Professor Gallo and Professor Montagnier; the latter would, in 2008, be awarded the Nobel Peace Prize in Medicine for discovery of HIV as a retro-virus.

At that time, Professor Bartholomew was amongst the elite few who contributed to the body of knowledge which would ultimately lead to the 1984 confirmation of the illness as the Human Immuno-deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).
Professor Bartholomew can be credited with diagnosing the first case of AIDS in Trinidad and Tobago. His interest in the developing epidemic remained evident and he was instrumental in providing early HIV drugs to infected individuals including pregnant women in Trinidad and Tobago.

In 2001, MRFTT’s internationally growing reputation led to the National Institute of Health (NIH) and UNAIDS, Geneva, asking MRFTT to participate in an international quest for an HIV/AIDS vaccine. This remarkable participation was successfully done and the MRFTT completed Phase 1 of the HVTN Clinical trials.

In 2002, the Government of Trinidad and Tobago negotiated a partnership with Professor Bartholomew when MRFTT was asked to be the lead clinical site for treatment and care services of HIV in Trinidad and Tobago, with external laboratory support from CAREC. Through this arrangement, anti-retroviral therapy would be also provided for clients.
In the years that would follow, the MRFTT would grow and prosper and the rapidly consistent growth of the clinic population would see a diversification and increase of its services with local and international collaborations.

Recognizing the value of having onsite CD4 and viral load testing prompted the building of the Kevin Babb Laboratory at MRFTT. Commissioned in 2005, the state of the art Laboratory would offer CD4 and Viral Load testing, as well as a suite of other tests including Hepatitis B sAg, Hepatitis B DNA, Hepatitis B eAg, Cryptcoccus Ag, Histoplasma Ab, HTLV-1, Toxoplasma Ab, Lymphocyte extraction for Proviral DNA and HTLV-1 Viral loads, and the processing and transport of HIV drug resistance test samples.

The MRFTT Laboratory continues to strengthen its services and is actively working towards ISO15189 Medical Laboratory Accreditation. The highly qualified laboratory technicians maintain quality standards that ensure reliable results, and on-going training and certification is a key component as this critical service continues to grow and strengthen.

The onsite Pharmaceutical service has maintained the highest quality and standards with the Head Pharmacist actively participating at ministerial level on newest drug options and combinations. Striving to ensure accuracy and service in a timely manner, the pharmacy staff would maintain strict recording systems in order to minimize or prevent stock outs.

Several important projects would be undertaken in the years to follow including the MRFTT collaborating with the Ministry of Health leading to the development of national guidelines including Prevention of Mother to Child Transmission (PMTCT) and Post exposure prophylaxis guidelines. Early leadership with the PMTCT program led the way for a robust national PMTCT structure that continues today and allows Trinidad and Tobago to maintain its incredibly low HIV-perinatal infection rate.

An electronic Medical Record system would be started in 2007, and the MRFTT would lead the way as the first public health unit in the country to completely transition their medical records system to a fully electronic medical record system.

Weekly education sessions led by Professor Bartholomew and supported by Dr Boyce, led to the building of an extensive body of knowledge among the staff of the MRFTT, and this would become an important factor for ensuring that treatment protocols were adhered to, in order to keep up with the dynamic nature of changing treatment protocols based on new findings. This then translated into maintaining the “Gold standard” care that Professor Bartholomew insisted on as his benchmark.

The rapid increase of its client population led to needs-based care in order to meet the changing demands of the clinic population, and this saw task shifting and specialized services including phlebotomy and psycho-social services being started. Furthermore, the MRFTT doctors started reviewing HIV clients warded at Caura Hospital (Tuberculosis), and the Port of Spain General Hospital-a relationship that remains in place to this time, with MRFTT doctors making monthly on-call rotations for currently warded MRFTT clients.

The Living Water Community would also partner with the MRFTT and together opened the Mercy Home Hospice which would serve as a lifeline for clients who needed hospice or palliative care.
Special attention and research activities into conditions including but not limited to late presenters, cancers, HTLV1, Hepatitis B and Natural Viral Suppressors would be undertaken under the supervision of Professor Bartholomew.

The need soon arose for Resistance testing and without these facilities being locally available, Professor Bartholomew fostered partnerships with the Ponce Health Sciences University, Puerto Rico, to perform Resistance testing for MRFTT clients. This relationship remains consistent to this day and has been pivotal and extremely important in informing clinicians due to the evolving complexities of HIV treatment.
Regional and international collaborations continued in the following years and would see the MRFTT become an active participant in the Trans-Caribbean HIV/AIDS Research Initiative (TCHARI), as junior and senior Caribbean scientists would work together to produce collaborative research as well as mentor-mentee programs.
Other international collaborations would be fostered with The University of California San Francisco’s Clinical Consultation Centre a.k.a. The Warm Line and The Lutheran Medical Centre in New York.

Staff development was gained at annual participation at the Conference on Retroviruses and Opportunistic Infections, and International AIDS Society conferences, where almost annually for many years, the MRFTT would be successful in having abstracts accepted for presentation.

In 2017, Dr. Robert Jeffrey Edwards, a specialist doctor with a wealth of experience in HIV, sexually transmitted infections (STI’s), Dermatology and Public Health, and a longtime associate of the MRFTT, accepted the leadership role of Executive Clinical Advisor of the organization, upon Professor Bartholomew’s retirement.
Ably assisted by his Deputy Director, Dr. Gregory Boyce the MRFTT leadership now lead their multi-disciplinary team to continue to provide the gold standard health care to clients, using sound scientific knowledge and research principles in a dynamic and ever changing health care environment.

Led by Dr. Edwards, the MRFTT has witnessed changes to its function and structure, and new and innovative approaches have been, and are being undertaken to meet the complexities that long term HIV treatment and care present.
The important need to retain clients in care has been met with a multi-pronged approach to contact clients via dedicated contact tracers, who provide psycho-social support and counseling as they engage clients and seek to mobilize them back to care and get them re-started on treatment. Both short term and long term defaulters are targeted and strategies are undertaken to maintain a better retention in care, and subsequent adherence on anti-retroviral therapy.
One important strategy to support the retention in care initiative is the extended clinic services with an Evening Clinic and early morning service. To date, these have proved to be very successful as clients can access treatment and care at non-traditional hours and as a result are less likely to default.

Specialized monthly clinics were started to meet specific client needs. The Adolescent Clinic was started to provide a service to HIV infected individuals who transitioned from Paediatric care to MRFTT’s adult care setting. The specialized services were created to meet specific criteria and the clinic has been successful in fulfilling its mission.

The Prison Clinic was started to shift access to care from MRFTT to one main prison site and this therefore would better meet imprisoned client’s needs in their familiar setting. The initiative highly supported by the Commissioner of Prisons has been successful in its mandate and has fostered improved safety, effectiveness, reach of care and resulted in an improved working relationship between the prison system and the MRFTT.

The Men’s clinic is in keeping with international trends to make specialized services available to men, particularly HIV positive men. The full suite of services is designed to meet clients at different stages on the health continuum and work with them to provide medical, psycho-social care and peer support.
A vaccine programme was also started by Dr.Edwards with the aim of preventing illness and promoting wellness for clients, especially in the provision of the HPV vaccine as it aims to prevent cervical cancer, one of the HIV-associated cancers.
Dr. Edwards has initiated many training and educational enhancement opportunities as he recognizes his staff as a valuable asset. To this end, the staff has engaged in many learning opportunities, notably the Key Populations Preceptorship programme, STI and dermatology updates, Psycho-social workshops and staff development training.

The MRFTT has been also re-positioned as a leader in providing educational outreach to local and regional partners as seen in the organization being approved in 2019 as a site for the University of Washington eDGH Online HIV course.
Notably, MRFTT started its newest role in being the parent site for the ECHO program which will see cooperative learning for health care workers from different treatment sites throughout Trinidad and Tobago, along with other countries including Bahamas, Barbados and St. Vincent.

A change to the physical environment and inclusion of peer support for clients via the Patient Advocate program have been additional initiatives all aimed at improving clients experiences at the MRFTT. Both have been met with good outcomes.
The MRFTT also now has bilingual (English/Spanish) staff and has also been making best use of the capacities of staff members promoting research, management, creativity, educational and many other skill sets.

The MRFTT born in 1982 to provide research to the University of the West Indies, has seen many changes and in fact the only consistency the organization has had, is change. The future though unknown, looks bright for an organization that continues to hold its own in local, regional and international settings.
Dr. Edwards is well positioned to steer the organization to chart its own course, in much the way that it has seemed destined to do from its inception.

Careers

At the Medical Research Foundation of Trinidad and Tobago, we acknowledge that out greatest resource is our human resource, whose expertise, caring and professionalism contribute to the excellent standard of service we aim to provide. If you would like to submit your application, we can commit to keep it on file and will contact you should a suitable vacancy arise.
To submit a job application, please send your cover letter and resume to hr@mrftt.org